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Cardiovascular Health Indicator
Measure: Stroke Hospitalization Rate
|Indicator||Date of Most Recent Measure||Current Measure||Trend|
|Age-Adjusted Hospitalization Rate due to Cerebrovascular Disease (Stroke)||2018||196.6
- In 2018, there were just over 13,000 hospitalizations of Minnesotans for stroke, or a rate of 197 hospitalizations per 100,000 people.
- The total number of annual stroke hospitalizations has stayed relatively steady from 2005 through 2015, but has increased by more than 1,000 from 2014 to 2018.
- The lowest stroke hospitalization rate in Minnesota was in 2015; the rate has increased slightly through 2018.
- The long-term decline in stroke hospitalization rates is limited to adults ages 65 and older. Adults younger than 65 have experienced slight increases in hospitalization rates between 2005 and 2018.
As shown in Table 1, the total number of hospitalizations of Minnesotans due to stroke and transient ischemic attacks (TIA) has remained fairly stable from 2005 through 2015, with an increase of more than 1,000 annual hospitalizations from 2015 through 2018. TIAs are temporary blockages in the blood supply to the brain. Sometimes these are called “mini-strokes.” The rate of hospitalization for all stroke and TIA declined in a steady fashion, until leveling out in recent years, as shown in Chart 1. The average hospitalization rate has been relatively stable since 2015, rising less than 5% over four years.
Table 1: Total Hospitalizations and Hospitalization Rate due to Stroke and TIA for all Minnesotans, 2005-2018
|Year||Number of Hospitalizations||Age-Adjusted Hospitalization Rate (per 100,000)|
Chart 1: Age-adjusted Hospitalization Rate due to Stroke and TIA for all Minnesotans, 2005-2018
Table 2 shows the number of hospitalizations and hospitalization rate by year for younger (ages 18-44), middle-aged (ages 45-64), and older (ages 65+) adults. In each year, the vast majority of hospitalizations is occurring in older adults 65 years and older. The overall decline in the rate of stroke and TIA hospitalization rates appears to be driven exclusively by declines in the rate of stroke among older adults aged 65 or older.
Table 2: Total Hospitalizations and Hospitalization Rate due to Stroke and TIA for adult Minnesotans by age group, 2005-2018
|Year||Number of Hospitalizations, ages 18-44 years||Hospitalization Rate, ages 18-44 years (per 100,000)||Number of Hospitalizations, ages 45-64 years||Hospitalization Rate, ages 45-64 years (per 100,000)||Number of Hospitalizations, ages 65+||Hospitalization Rate, ages 65+ years (per 100,000)|
Chart 2A shows the rate of hospitalizations for stroke for 18-44 year olds. Between 2005 and 2016, the overall rate has remained essentially unchanged, hovering between 26 and 30 hospitalizations per 100,000 per year. In 2017 and 2018, the hospitalization rate exceeded 30 per 100,000 per year, higher than in any year going back to 2005. In 2018, the number of stroke hospitalizations in younger adults was at its highest level as far back as 2005.
Chart 2A: Hospitalization Rate due to Stroke and TIA for Minnesotans ages 18-44, 2005-2018
Chart 2B shows the hospitalization rate for stroke for 45-64 year olds. Like for younger adults, the overall hospitalization rate has remained essentially unchanged over the 2005 to 2015 time period, hovering between 201 and 212 hospitalizations per 100,000 per year. Since 2013, the rate has increased by 34 hospitalizations per 100,000 per year, of about 17%.
Chart 2B: Hospitalization Rate due to Stroke and TIA for Minnesotans ages 45-64, 2005-2018
Chart 2C shows the rate of hospitalizations for stroke for individuals 65 years and older. Between 2005 and 2018, the overall rate dropped by 360 hospitalizations per 100,000 per year, or about 26%. Unlike in the younger and middle-aged adults, this long-term decline has been consistent through 2016, followed by very little change in the hospitalization rate from 2016 through 2018. Even though the annual hospitalization rate in older adults has been stable in recent years, this group experienced approximately 1,000 more strokes in 2018 compared to 2014.
Chart 2C: Hospitalization Rate due to Stroke and TIA for Minnesotans ages 65+, 2005-2018
- Interactive Atlas of Heart Disease & Stroke
Online mapping tool from CDC with health indicators (including mortality and hospitalizations), risk factors, social and economic data, health care delivery, insurance, and health care costs data for states and counties. Some census tract data is also available.
- AHRQ HCUPNet
Online data tool from the Agency for Healthcare Research and Quality (AHRQ) for the Healthcare Cost and Utilization Project (HCUP). Users can download quick tables or create custom queries of national and state-level data on inpatient hospitalization, emergency department, and ambulatory surgery care.
The data were obtained through the Minnesota Hospital Discharge Dataset, also known as the Minnesota Hospital Uniform Billing (UB) Claims Data, provided to the Health Economics Program at the Minnesota Department of Health by the Minnesota Hospital Association. The dataset captures hospitalizations for Minnesota residents and comes from Minnesota hospitals (except for Federal Hospitals owned by the Veterans Administration or the Indian Health Service) or other states that share data with the state of Minnesota (including the bordering states of Iowa, North Dakota, and South Dakota; hospitalizations that occur in Wisconsin for Minnesota residents are not included/shared). Annual population estimates were obtained through the U.S. Census Bureau in collaboration with the National Center for Health Statistics.
Cerebrovascular Disease (Stroke) hospitalizations through September 30, 2015 are identified as the primary discharge diagnosis of ICD-9: 430-438, including Hemorrhagic Stoke as ICD-9: 430-431, Ischemic Stroke as ICD-9: 434 and 436, and Transient Ischemic Attack (TIA) as ICD-9: 435. Starting on October 1, 2015, hospitalizations for cerebrovascular disease (stroke) were identified as the primary discharge diagnosis as ICD-10: I60-I69, including Hemorrhagic Stroke as ICD-10: I60-I62, Ischemic Stroke as ICD-10: I63, and Transient Ischemic Attack (TIA) as ICD-10: G45.9. Patients who are discharged to another hospital are excluded so as to prevent double-counting single events resulting in hospitalizations at multiple facilities.
The change from ICD-9 to ICD-10 introduces some uncertainty in the trend from 2014 through 2016, , because changes in coding may lead to differences in classification of conditions before and after the transition.